Medicare bill a dilemma for lawmakers

Mikulski is concerned drug benefit she backed is being rushed into law

November 21, 2003|By Julie Hirschfeld Davis | Julie Hirschfeld Davis,SUN NATIONAL STAFF

WASHINGTON - When Sen. Barbara A. Mikulski visited Leisure World in Montgomery County earlier this year, she got an earful from seniors who felt shortchanged by the prescription drug benefit in the Medicare bill Congress had just passed with her help.

Now, Congress is on the verge of voting to send President Bush the measure, which would provide what seniors have long clamored for: government aid to help them pay for medicine. But it still falls short of what many had hoped for. And Mikulski, a Maryland Democrat who is up for re-election next year, is torn.

Many Democrats denounce the bill as a raw deal that offers inadequate drug coverage in return for harmful provisions that would privatize Medicare and send premiums skyrocketing. Sen. Edward M. Kennedy of Massachusetts, the Democrats' most trusted voice on health care, fiercely opposes the bill and is working to defeat it.

But many lawmakers in both parties say the legislation would shore up Medicare and seize what could be Congress' last chance for years to add a drug benefit. In a big boost for the measure, AARP, the influential group that represents 35 million seniors, has endorsed it and is lobbying hard for its approval.

That has left Democrats - long the strongest proponents of Medicare and the first to push for prescription drug coverage - in a quandary. The dilemma is particularly acute for those who face voters next November.

As negotiators met to finalize the bill, proponents were trolling for support among wavering senators, particularly Democrats. The House could pass the measure as early as tonight, and leaders expressed confidence that they would have the votes to do so.

In the Senate, where a final vote is likely by next week, Mikulski is one of about 10 wavering Democrats being lobbied to back the bill. Three others - Sens. Mary L. Landrieu of Louisiana, Blanche Lincoln of Arkansas and Ben Nelson of Nebraska - announced their support for it yesterday.

"Anybody who votes against a prescription drug plan, with all the support it has, is fighting, I think, what the majority of seniors want," said Sen. John B. Breaux, a Louisiana Democrat who joined with Republicans to craft the Medicare deal that leaders hope to clear for Bush by Thanksgiving.

Then he stepped aside to take a cell-phone call from a House Democrat who's grappling with whether to back the measure.

"We're picking people off - one by one by one," said Bette Phelan, Breaux's spokeswoman. "Everybody's looking for cover, especially those who are up for re-election."

Outside groups that support the bill have also stepped up the pressure. The United Seniors Association, a conservative group, is running TV ads hailing Mikulski for her "historic vote" for the earlier bill. The ads exhort people to call Mikulski and "thank her for her leadership. Because seniors are too close to getting the drug benefit they need to let it slip away now."

The group, which has collaborated with the pharmaceutical industry on previous ad campaigns for the Medicare bill, is targeting 14 other senators with similar ads. It is also focusing on 58 House members, including Rep. Roscoe G. Bartlett, a conservative Western Maryland Republican who has complained that the bill is too costly.

Mikulski, a member of the Health, Education, Labor and Pension Committee, has been active on health care matters and seniors' issues. But in a sign of how politically delicate the Medicare measure has become, she declined to be interviewed about her position on it, relaying through a spokeswoman that she is still undecided.

"I am very concerned that the Medicare bill is being pushed too quickly," she said in a statement, noting that few have had the chance to examine the bill, which runs more than 1,000 pages. "I want time to study the bill and talk to Maryland seniors about what it means for them."

Even as lawmakers were doing the calculations - both of the drug costs and the political consequences of voting for or against the bill - the details were evolving. Negotiators sweetened the drug benefit yesterday that seniors would receive under Medicare, lowering the deductible from $275 to $250. They also raised, from $2,200 to $2,250, the level of drug costs for which the elderly would receive a 75 percent government subsidy.

Seniors would pay about $35 a month for the coverage. They would have to pay for all their medicines between $2,251 and $3,600, beyond which the government would cover 95 percent of costs.

The benefit would start in 2006. Seniors would get a drug discount card next year to tide them over, with savings of up to 25 percent on prescriptions.

The elderly, who vote in disproportionately large numbers, have demanded such coverage for years. But Democratic leaders and an army of labor groups and senior organizations other than AARP are fighting the bill.

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